4 Things You Should Know If You Take NSAIDs for Chronic Back Pain

Doctors occasionally recommend taking NSAIDs every day for more than 10 days (for example, up to six weeks) to see how well they fix your pain, says Dr. Habibi. You may find that your aches clear up in that window. But if not, depending on your health history, it might be okay to keep taking these meds two to three times a week until your symptoms improve, Dr. Habibi says. Otherwise, he doesn’t recommend taking OTC NSAIDs every day unless you’re closely working with a doctor who’s tracking your blood work and blood pressure to make sure the medications aren’t causing any issues.

3. Think twice before combining drugs.

You’ll also want to be careful when mixing NSAIDs with other things you are taking. According to Shimono, this can affect how well each of them works and increase health risks. For example, stomach bleeding is a big concern when you combine NSAIDs and blood thinners—which, as a general rule, Dr. Habibi says to avoid. Also, think twice if you are on proton pump inhibitors, which are commonly used to treat acid reflux; steroids, which are inflammation-fighting drugs; or diuretics and other high blood pressure meds. While Dr. Habibi says it’s not as dangerous to take these with ibuprofen or naproxen (compared to blood thinners), if you need to do so, then it’s a good idea to ping your doctor first. They may want to monitor your blood pressure and kidneys or give you a muscle relaxant or a topical anti-inflammatory gel, like diclofenac or trolamine salicylate, instead.

Another thing to be wary of? Mixing different types of NSAIDs. Dr. Habibi says he commonly sees patients who take ibuprofen for back pain and aspirin for chronic heart and vascular issues. But popping two types of NSAIDs around the same time can increase your risk of stomach irritation or, more seriously, a GI bleed. Internal stomach bleeding can show up as bloody poop or vomit or present no symptoms at all but slowly and silently cause anemia, a condition where there aren’t enough healthy red blood cells to carry oxygen to your tissues. If you absolutely must mix different types of NSAIDs, talk to your doctor first, Dr. Habibi says.

4. They aren’t the best pain relievers for everyone.

Though NSAIDs might do wonders for your back, if you have a history of heart disease, stroke, ulcers, or gastritis, which is an inflammation of the stomach lining, you are more likely to have problems if you take them for a long time. If you’ve had any of these issues, it might be best to skip ibuprofen and naproxen altogether, only use them for a week or two, or opt for a prescription NSAID such as meloxicam or celecoxib. Dr. Habibi says the Rx versions may be easier for some people to tolerate. (Your stomach may thank you.) If you have any preexisting conditions, definitely ask your doctor what type of pain reliever you should take. They can also ensure you’re getting the most out of your NSAIDs—by, for example, finding the right dose for your situation and tracking how your body responds to it—while helping you dodge some of those risks.

If this sounds a bit scary, know that generally speaking, NSAIDs are pretty safe—it just requires some planning. When you take NSAIDs for back pain, the goal is to make a noticeable difference in your pain levels, Dr. Habibi says. If they aren’t helping that much, it may be best to skip them. “If you’re taking them and not seeing any pain relief, it’s not worth the risks,” he says. Your doctor may offer another solution to make your back pain more manageable, such as physical therapy, prescription medications, or injections. But if NSAIDs make your life a little easier, that’s a big deal, Dr. Habibi points out.

They can absolutely be game changers, but these little pills pack a punch, so you just want to make sure you’re taking NSAIDs as intentionally—and safely—as possible.

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